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AN – FBT — RACP Paediatrics MCQ

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HardEmergencyAN – FBTRACP Paediatrics

A 15-year-old with restrictive eating has heart rate 38/min asleep and 44/min awake, postural systolic drop 24 mmHg, phosphate 0.62 mmol/L and temperature 35.7°C. BMI is at the 35th centile. Which disposition is most appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Admit for medical stabilisation and monitored nutritional rehabilitation

Explanation lettering: B = shown as A · D = shown as B · E = shown as C · A = shown as D · C = shown as E

E is correct. Severe bradycardia, postural compromise, hypothermia and hypophosphataemia indicate medical instability and refeeding risk regardless of BMI; inpatient monitored stabilisation is required. A incorrectly uses weight alone. B underestimates immediate cardiac and electrolyte risk. C psychiatric care without medical monitoring is unsafe. D rapid unmonitored refeeding risks further electrolyte shifts and arrhythmia.

Reference: RCH Melbourne, Management of eating disorders in the emergency department: https://www.rch.org.au/clinicalguide/guideline_index/Management_of_Eating_Disorders_in_the_Emergency_Department/